How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $154.88 Median $2,818.38 Typical High $4,786.30 | Facility | None | $154.88 | $2,818.38 | $4,786.30 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $234.42 | Professional | None | $144.54 | $190.55 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $1,380.38 | Professional | None | $154.88 | $173.78 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $630.96 | Professional | None | $138.04 | $218.78 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $524.81 | Professional | None | $251.19 | $354.81 | $524.81 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,071.52 Typical High $5,128.61 | Facility | None | $398.11 | $1,071.52 | $5,128.61 |
United Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $575.44 | Professional | None | $128.82 | $251.19 | $575.44 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $74.13 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.02 Typical High $46.77 | Professional | 53 · Discontinued | $29.51 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $112.20 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $22.39 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $14.79 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $104.71 | $134.90 | $162.18 |
Where Washington, DC sits
The same service costs 3.5 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Washington, DC· 36th of 51
$209
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.